Existing law, the Knox-Keene Health Care Service Plan Act of 1975, provides for the licensure and regulation of health care service plans by the Department of Managed Health Care and makes a willful violation of the act a crime. Existing law also provides for the regulation of health insurers by the Department of Insurance. Existing law requires an individual or small group health care service plan contract or health insurance policy to include, at a minimum, coverage for essential health benefits, as specified. Commencing January 1, 2027, if the United States Department of Health and Human Services approves a new essential health benefits benchmark plan for the state, existing law requires essential health benefits to include an annual hearing exam and one hearing aid per ear every three years. This bill, the Let California Kids Hear Act, would require a large group health care service plan contract or health insurance policy issued, amended, or renewed on or after January 1, 2028, to include coverage for hearing aids, as defined, and related services for enrollees and insureds under 21 years of age, if medically necessary. The bill would authorize a large group health care service plan contract or health insurance policy to limit the dollar coverage for each individual hearing aid device to $3,000, as specified. Because a willful violation of these requirements by a health care service plan would be a crime, the bill would impose a state-mandated local program. The California Constitution requires the state to reimburse local agencies and school districts for certain costs mandated by the state. Statutory provisions establish procedures for making that reimbursement. This bill would provide that no reimbursement is required by this act for a specified reason.
Existing law provides for the licensure and regulation of alcohol or other drug recovery or treatment facilities by the State Department of Health Care Services. Existing law prohibits operating an alcohol or other drug recovery or treatment facility to provide recovery, treatment, or detoxification services within this state without first obtaining a current valid license. If a facility is alleged to be providing those services without a license, existing law requires the department to conduct a site visit to investigate the allegation. Existing law also authorizes the department to conduct announced or unannounced site visits to licensed facilities for the purpose of reviewing them for compliance, as specified. Existing law requires alcohol or other drug programs to be certified by the department, except as specified. Existing law prohibits those programs from operating without a certification. If a program is alleged to be providing services without a certification, existing law requires the department to conduct a site visit to investigate the allegation. Existing law also authorizes the department to conduct announced or unannounced site visits to certified programs for the purpose of reviewing them for compliance, as specified. This bill would require the department to assign a complaint under its jurisdiction regarding a licensed alcohol or other drug recovery or treatment facility or a certified alcohol or other drug program to an analyst for investigation within 10 days of receiving the complaint. If the department receives a complaint that does not fall under its jurisdiction, the bill would require the department, to the extent feasible, to notify the complainant, in writing, that it does not investigate that type of complaint. The bill would require the department to complete an investigation into a complaint regarding a facility within 120 days of assigning the complaint unless the department requires additional resources, as specified, to complete the investigation. Commencing July 1, 2027, and each July 1 thereafter, the bill would require the department to post on its internet website an annual report of the investigations conducted by the department, as specified. The bill would authorize the department to impose a single fee increase for the licensure of facilities and certification of programs, as described above, commensurate with the reasonable cost of preparing and maintaining the report.
Existing law establishes the Medi-Cal program, which is administered by the State Department of Health Care Services and under which qualified low-income individuals receive health care services, including emergency or nonemergency medical or nonmedical transportation services. The Medi-Cal program is, in part, governed and funded by federal Medicaid program provisions. Under this bill, commencing on July 1, 2027, and subject to an appropriation, Medi-Cal fee-for-service reimbursement for nonemergency ambulance transportation services, as defined, would be in an amount equal to 80% of the amount set forth in the federal Medicare ambulance fee schedule for the corresponding level of service, adjusted by the Geographic Practice Cost Index, as specified. The bill would require the department to establish a Medi-Cal managed care directed payment program for nonemergency ambulance transportation services, with the reimbursement rates set in an amount equal to at least the amount set forth under fee-for-service reimbursement. The bill would require the department to maximize federal financial participation in implementing the above-described provisions to the extent allowable. To the extent that federal financial participation is unavailable, the bill would require the department to implement the provisions using state funds, as specified. Under the bill, whenever the medical necessity of nonemergency ambulance transportation services needs to be certified for purposes of Medi-Cal coverage, either a physician or a nonphysician authorized under certain federal regulations would be permitted to complete that certification, as specified. The bill would require the department to revise and update the Medi-Cal provider manual or any guidance, as applicable, to implement this provision. Existing Medi-Cal regulations require that records of medical transportation providers include, among other information, odometer readings at each pickup and delivery location. Under this bill, for purposes of documenting mileage in their records under the Medi-Cal program, medical transportation providers would be authorized to utilize vehicle Global Positioning System (GPS) tracking, digital mapping software or applications, or another reasonable mechanism identified by the department, as specified, in addition to the above-described odometer readings. The bill would require the department to revise and update any corresponding regulations, including the above-described provision.
Existing law requires a licensed health care practitioner who provides prenatal, postpartum, or interpregnancy care for a patient to offer to screen or appropriately screen a mother for maternal mental health conditions. For purposes of that requirement, existing law defines "maternal mental health condition" to mean a mental health condition that occurs during pregnancy, the postpartum period, or interpregnancy, as specified. This bill would limit the definition of "maternal mental health condition" to a mental health condition that occurs during the pregnancy or the postpartum period, as specified. The bill would authorize a licensed health care practitioner to satisfy the above-described requirement for maternal mental health screening by referring the patient or client to another licensed health care practitioner who is authorized to screen, evaluate, diagnose, and treat the patient or client for a maternal mental health condition. The bill would require a licensed health care practitioner who provides prenatal, postpartum, or perinatal care for a patient or client who screens positive for a maternal mental health condition to ensure that the patient or client receives appropriate clinical evaluation, and, if the practitioner diagnoses a patient or client with a maternal mental health condition, offer or provide treatment to the patient or client, consistent with the provider's scope of practice. Existing law, the Knox-Keene Health Care Service Plan Act of 1975, provides for the licensure and regulation of health care service plans by the Department of Managed Health Care and makes a willful violation of the act a crime. Existing law provides for the regulation of health insurers by the Department of Insurance. Existing law requires a health care service plan or health insurer to develop a maternal mental health program designed to promote quality and cost-effective outcomes. Existing law requires the program to, among other things, conduct specified maternal mental health screenings during pregnancy and the postpartum period. Existing law requires the program guidelines and criteria to be provided to relevant medical providers, including all contracting obstetric providers. Existing law encourages health care service plans and health insurers to, among other things, improve screening, treatment, and referral to maternal mental health services. For purposes of these provisions, existing law defines "maternal mental health" to mean a mental health condition that occurs during pregnancy or during the postpartum period, as specified. This bill would modify the term to "maternal mental health condition" and define it as a mental health condition that occurs during the pregnancy or the postpartum period, as defined by the most recent clinical guidelines adopted by the American College of Obstetricians, as specified. The bill would instead require the above-described maternal mental health program to include maternal mental health screening to be conducted during pregnancy and one or more mental health screenings to be conducted during the postpartum period in accordance with applicable clinical guidelines and the standards of care appropriate to the provider's scope of practice, as specified. The bill would require program guidelines and criteria to be provided to relevant licensed health care practitioners, as defined, including all contracting obstetric providers. The bill would require a health care service plan or health insurer to provide case management or care coordination for an enrollee or insured who screens positive for a maternal mental health condition in accordance with the plan's or insurer's existing case management and care coordination programs. The bill would encourage health care service plans and health insurers to improve treatment, including through the use of outpatient prescription drugs approved for maternal mental health by the United States Food and Drug Administration. Because a willful violation of these provisions by a health care service plan would be a crime, the bill would impose a state-mandated local program. The California Constitution requires the state to reimburse local agencies and school districts for certain costs mandated by the state. Statutory provisions establish procedures for making that reimbursement. This bill would provide that no reimbursement is required by this act for a specified reason.
This California resolution proclaims September 2026 as Sepsis Awareness Month within the state. The measure was adopted by the legislature and signed into law as Chapter 218 of the 2026 Statutes. It serves to formally designate the month for public recognition of sepsis, a serious medical condition.
Existing federal law, the Community First Choice Option (CFCO) program, authorizes states to provide home- and community-based attendant services and supports to eligible Medicaid enrollees, as specified. Existing federal law provides federal financial participation for a state that provides services under the CFCO program. Existing state law establishes the In-Home Supportive Services (IHSS) program, administered by the State Department of Social Services and counties, under which qualified aged, blind, and disabled persons are provided with services in order to permit them to remain in their own homes. Existing law requires the state and counties to share the annual cost of providing IHSS pursuant to a specified cost ratio. Existing law requires all counties to have a rebased County IHSS Maintenance of Effort (MOE) and requires the rebased MOE to be adjusted for the annualized cost of increases in provider wages, health benefits, or other benefits, as prescribed. Existing law, commencing July 1, 2026, requires a county to pay, separate from the rebased County IHSS MOE payment, a 100% share of the enhanced federal financial participation that would have been received if the state ceases to receive that funding for the provision of services due to noncompliance of timely case reassessment for the federal CFCO program. This bill would require the department to, on or before July 1, 2029, prepare and submit to the Legislature a report on the amount of the above-described payments made by counties due to noncompliance of timely case reassessment for the federal CFCO program.
Existing law, the Knox-Keene Health Care Service Plan Act of 1975, provides for the licensure and regulation of health care service plans by the Department of Managed Health Care, and makes a willful violation of the act a crime. Existing law provides for the regulation of health insurers by the Department of Insurance. Existing law requires a health care service plan contract or health insurance policy to provide coverage for behavioral health treatment for pervasive developmental disorder or autism. Existing law requires this treatment to be provided under a prescribed treatment plan that is reviewed no less than every 6 months by the qualified autism service provider. This bill would prohibit a health care service plan or health insurer from imposing restrictions on the utilization of authorized treatment hours within the treatment plan's 6-month authorization period. The bill would require authorized hours to remain available for use throughout the authorization period if the use of the hours is consistent with the treatment plan and clinical guidelines, and is documented in the treatment plan and progress reports. Because a willful violation of these provisions by a health care service plan would be a crime, the bill would impose a state-mandated local program. The California Constitution requires the state to reimburse local agencies and school districts for certain costs mandated by the state. Statutory provisions establish procedures for making that reimbursement. This bill would provide that no reimbursement is required by this act for a specified reason.
Existing law provides that reproductive health care services, gender-affirming health care services, and gender-affirming mental health care services are rights secured by the Constitution and laws of California, and interference with these rights, whether or not under the color of law, is against the public policy of California. Existing law defines "gender-affirming health care services" to mean medically necessary health care that respects the gender identity of the patient, as experienced and defined by the patient, as specified. Existing law provides for various protective measures for persons engaging in legally protected health care activity, including prohibiting a provider of health care, health care service plan, health insurer, or contractor from releasing medical information related to, among other things, an individual seeking or obtaining gender-affirming health care or gender-affirming mental health care, and prohibiting a state or local public agency, or any employee thereof acting in their official capacity, from cooperating with or providing information to an individual or agency from another state or a federal law enforcement agency, as specified, regarding a legally protected health care activity that is lawful in this state and performed in this state. Existing law defines "legally protected health care activity" for those purposes to include, among other things, the exercise and enjoyment, or attempted exercise and enjoyment, by a person of rights to the health care services described above and the provision of those health care services by a person duly licensed under the laws of California. This bill would require a person or entity that is located, headquartered, incorporated, or otherwise conducting business in California and receives, is served with, or is subject to a subpoena, discovery request, or other request for information that is part of a legal process related to a civil, criminal, regulatory, or legislative investigation regarding abortion, as defined, or gender-affirming health care services that are legally protected health care activities secured by the Constitution or laws of California to provide specified notice to the Attorney General at least 7 business days prior to producing records in response to the request unless a shorter response time is required by federal law or other federal obligation, as specified. If a shorter response time is required by federal law or other federal obligation, the bill would require the responding person or entity to provide notice to the Attorney General no later than contemporaneously with producing the responsive records. The bill would exempt a person or entity from the notice requirement if the subpoena, discovery request, or other request for information meets certain requirements, including that it is accompanied by an attestation verifying that the use or disclosure of the requested information meets certain requirements, including that the requested information is related to an investigation or proceeding regarding activity that is unlawful under California civil or criminal law, and it identifies the California law under which the activity is unlawful. The bill would prohibit a person or entity receiving, served with, or subject to a subpoena, discovery request, or other request for information described above who is not subject to the above-described exemption from producing the responsive records until at least 7 business days after providing notice to the Attorney General unless a shorter response time is required by federal law or other federal obligation, as specified. If a shorter response time is required by federal law or other federal obligation, the bill would require the responding person or entity to make best efforts to deliver the responsive records on the date on which the person or entity is required to respond to the subpoena, discovery request, or other request for information. The bill would authorize the Attorney General to make reasonable attempts to notify the individual who provided, sought, received, facilitated, or otherwise engaged in the abortion or gender-affirming health care service pertaining to the subpoena, discovery request, or other request for information. The bill would entitle a person or entity subject to these provisions to rely on the representations made in an attestation described above. The bill would authorize the Attorney General to intervene in any civil action instituted by a person or entity to protect against compliance with or providing information in response to the subpoena, discovery request, or other request for information. The bill would authorize the Attorney General to commence certain actions, including a civil action against any person or entity that attaches a false attestation described above, and would make the attachment of a false attestation by a person or entity punishable by a civil penalty of $15,000, as specified. The bill would require any action brought by the Attorney General to be commenced within 6 years of the date on which the Attorney General received the notice of the subpoena, discovery request, or other request for information at issue, and would require the court to award court costs and attorney's fees to the Attorney General in any civil action in which the court imposes any penalty authorized by the bill's provisions.
Existing law requires the State Department of Public Health to license and regulate various health facilities, including general acute care hospitals. Existing law requires the department to issue a special permit, in addition to a license, to a health facility to offer one or more special services, such as an emergency center, if specified requirements are met, including that the department finds that the standards of care and services are adequate and appropriate. Existing law requires the department to issue a special permit to allow a general acute care hospital to offer emergency stabilization services at a location that is neither inside nor contiguous to the applicant hospital if the hospital provides satisfactory evidence to the department that, among other things, the hospital has a written transfer agreement with the hospital closest to the location where emergency stabilization services will be provided and satisfactory evidence to the department that this location meets certain requirements, including that the location is in the town of Paradise within the County of Butte and serves the same area previously served by Feather River Hospital. This bill would require the department to issue a waiver, as specified, to a publicly owned and operated general acute care hospital, in collaboration with Del Puerto Health Care District, to operate one rural emergency stabilization care unit and waive designated general acute care hospital licensure requirements if specified conditions are met. The bill would limit the term of the waiver based on prescribed factors, including the completion of a hospital build within a 5-mile radius of the emergency stabilization care unit or within 10 years from the initial issuance of the waiver, except as specified. This bill would make legislative findings and declarations as to the necessity of a special statute for Del Puerto Health Care District.
(1) The Confidentiality of Medical Information Act (CMIA) prohibits a provider of health care, a health care service plan, a contractor, or a corporation and its subsidiaries and affiliates from intentionally sharing, selling, using for marketing, or otherwise using any medical information, as defined, for any purpose not necessary to provide health care services to a patient, except as provided. Existing law makes a violation of these provisions that results in economic loss or personal injury punishable as a misdemeanor. Existing law deems a business that offers a mental health digital service or reproductive or sexual health digital service to a consumer for the purpose of allowing the individual to manage the individual's information, or for the diagnosis, treatment, or management of a medical condition of the individual, to be a provider of health care subject to the requirements of the CMIA. The bill would additionally deem a business that offers a health care chatbot, as defined, to a consumer for the above-described purposes to be a provider of health care subject to the requirements of the CMIA. Because the bill would expand the scope of a crime, it would impose a state-mandated local program. (2) Existing law requires a health facility, clinic, physician's office, or office of a group practice that uses generative artificial intelligence to generate written or verbal patient communications pertaining to patient clinical information, as defined, to ensure that those communications include both a disclaimer that indicates to the patient that a communication was generated by generative artificial intelligence, as specified, and clear instructions describing how a patient may contact a human health care provider, employee, or other appropriate person, except as specified. This bill would require a health facility, clinic, physician's office, or office of a group practice to take reasonable steps to ensure that a licensed health care professional, acting within their scope of practice, retains the ability to exercise independent professional judgment in their care of a patient whenever that care is informed by the output of a clinical decision support system, as defined. The bill would prohibit a health facility, clinic, physician's office, or office of a group practice from using or deploying a tool, system, or device that includes artificial intelligence to independently perform any clinical function that is required by law to be performed by a person with a professional license. The bill would make a violation of these provisions by a physician subject to the jurisdiction of the Medical Board of California or the Osteopathic Medical Board of California. The bill would also authorize the appropriate professional licensing board to pursue an injunction or restraining order to enforce these provisions to the extent that a violation constitutes the practice of a health care profession without a license. The bill would specify that these provisions do not apply to the use of automated decision systems for documentation and communication that does not involve the application of professional judgment, including automated messages to inform patients of updates to their health records. (3) The California Constitution requires the state to reimburse local agencies and school districts for certain costs mandated by the state. Statutory provisions establish procedures for making that reimbursement. This bill would provide that no reimbursement is required by this act for a specified reason.
